Healthcare Provider Details

I. General information

NPI: 1538076831
Provider Name (Legal Business Name): KEVIN LYNCH PT, DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SERPENTINE RD
BALTIMORE MD
21209-2010
US

IV. Provider business mailing address

1021 GREENSPRING VALLEY RD
LUTHERVILLE TIMONIUM MD
21093-3644
US

V. Phone/Fax

Practice location:
  • Phone: 410-403-3060
  • Fax:
Mailing address:
  • Phone: 443-289-1682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number30864
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: